title: Serum albumin level is a notable profiling factor for non-B, non-C hepatitis virus-related hepatocellular carcinoma: A data-mining analysis.
abstract: OBJECTIVE
  Various factors are underlying for the onset of non-B, non-C hepatitis virus-related hepatocellular carcinoma (NBNC-HCC). We aimed to investigate the independent risk factors and profiles associated with NBNC-HCC using a data-mining technique.
  
  
  METHODS
  We conducted a case-control study and enrolled 223 NBNC-HCC patients and 669 controls from a health checkup database (n = 176 886). Multivariate analysis, random forest analysis and a decision-tree algorithm were employed to examine the independent risk factors, factors distinguishing between the case and control groups, and to identify profiles for the incidence of NBNC-HCC, respectively.
  
  
  RESULTS
  In multivariate analysis, besides γ-glutamyltransferase (GGT) levels and the Brinkman index, albumin level was an independent negative risk factor for the incidence of NBNC-HCC (odds ratio = 0.67; 95% confidence interval = 0.60-0.70; P < 0.0001). In random forest analysis, serum albumin level was the highest-ranked variable for distinguishing between the case and control groups (98 variable importance). A decision-tree algorithm was created for albumin and GGT levels, the aspartate aminotransferase-to-platelet ratio index (APRI) and the Brinkman index. The serum albumin level was selected as the initial split variable, and 82.5% of the subjects with albumin levels of less than 4.01 g/dL were found to have NBNC-HCC.
  
  
  CONCLUSIONS
  Data-mining analysis revealed that serum albumin level is an independent risk factor and the most distinguishable factor associated with the incidence of NBNC-HCC. Furthermore, we created an NBNC-HCC profile consisting of albumin and GGT levels, the APRI and the Brinkman index. This profile could be used in the screening strategy for NBNC-HCC.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawaguchi
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Fukushima
authors.forename: Ryoko
authors.initials: R
authors.lastname: Kuromatsu
authors.forename: Shuji
authors.initials: S
authors.lastname: Sumie
authors.forename: Akio
authors.initials: A
authors.lastname: Takata
authors.forename: Masahito
authors.initials: M
authors.lastname: Nakano
authors.forename: Manabu
authors.initials: M
authors.lastname: Satani
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Tonan
authors.forename: Kiminori
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Hiroji
authors.initials: H
authors.lastname: Shima
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kakuma
authors.forename: Takuji
authors.initials: T
authors.lastname: Torimura
authors.forename: Michael R
authors.initials: MR
authors.lastname: Charlton
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
keywords: lifestyle; metabolism; non-viral-related hepatoma; smoking